Alpha-2-macroglobulin concentrations may be increased in liver diseases such as cirrhosis and chronic and acute hepatitis, as well as in diabetes mellitus and the nephrotic syndrome. Increased levels have also been reported in neural tube defects, ataxia telangiectasia, atopic dermatitis, and Down’s syndrome. Concentrations may be decreased in gastroenteropathies, protein malnutrition and with fibrinolytic therapy.